Saskia Baltrusch

245 Chapter 9 Implications for practice and future research An important implication from this thesis is that the optimal design of an exoskeleton is context-dependent. When implementing it in the working environment, an exoskeleton needs to be adapted to the job and the end-users’ needs. A first step of doing that is talking to potential end-users, as done in this thesis. By recruiting potential end-users when testing the SPEXOR exoskeleton (Chapter 5), namely employees with and without a history of low-back pain, the acceptability assessment becomes even more valuable. As potential end-users, who daily deal with high mechanical loading on the back, these employees can best estimate whether the design of the SPEXOR exoskeleton will be suited for daily use in their working environment. Certainly, this also indicates that an exoskeleton design is task- or job-dependent. Asking employees from different occupations leads to different design requests or challenges that have to be considered when developing an exoskeleton. As an example, the participants in Chapter 8 were concerned about sitting with the exoskeleton. As the SPEXOR design consists of a spinal module on the back, users cannot comfortably sit when wearing the device. Luggage handlers, however, sit in vehicles frequently when moving the luggage from the hall to the platform. Another study identified barriers and facilitators of exoskeleton implementation in the operating room [13]. Major concerns mentioned by the surgeons were sterility and safety. Thus, barriers of exoskeleton implementation are dependent on the working environment that the exoskeleton is implemented in. Therefore, results of this thesis cannot be generalized to end-users of other working environments. Further research is needed when developing an exoskeleton in another vocational context. Still, it also indicates how “personalized” the SPEXOR design is, which was the aim when applying a user-centered approach. A step that is still missing and is essential when it comes to designing a context- dependent exoskeleton, is actual field testing. Giving the employees the possibility to try out the exoskeleton during a whole working day, might yield new insight into design requirements for the device and adaptations that still have to be done to make the exoskeleton suitable for their specific job. A laboratory mock-up cannot simulate the dynamic behavior in the work environment, which makes field studies indispensable [14]. After adapting the SPEXOR design, based on 9